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Possible side effects

It's important that you know and understand the side effects you may experience while taking SUTENT® (sunitinib malate). Some of these side effects you and your doctor may be able to manage. Other side effects may not be manageable. If you’re having some side effects, your doctor may decide to adjust your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Be sure to pay attention to all your side effects. They may be signs that let you and your doctor know what is happening in your body. Work with your healthcare team to determine when to call with questions or concerns. The sooner your team knows about your side effects, the sooner they can help you manage them if possible.

Common SUTENT side effects
Click each of these common side effects to learn more and, where tips are available, find out how to address the side effect.

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

Skin conditions as a result of your treatment do not usually pose health risks. However, a rash, dry, thick, callusing, cracking, widespread blistering, or peeling of the skin may be a sign of a more serious side effect. Call your doctor right away if you experience these symptoms. Treatment with SUTENT may also cause changes in skin or hair color. Because your medicine inside the capsule is yellow, it may make your skin and hair look yellow or get lighter in color. While this side effect usually poses no health risks, yellow skin can be a sign of a more serious side effect.

  • Maintain a balanced diet, while cutting down on salt
  • Walk and exercise. This can help increase circulation and reduce swelling
  • Wear compression socks or elastic sleeves. This can help with your circulation and reduce swelling
  • Elevate your arms or legs when sitting or lying
  • Wear thick cotton gloves and/or socks in order to protect your skin
  • Avoid tight footwear and excessive friction
  • Avoid hot water when washing hands, bathing, or showering
  • Take natural diuretics such as green, leafy vegetables (especially if you are taking enemas)
  • Your doctor my prescribe diuretics
  • Ask your doctor or nurse to perform a full evaluation
  • Your doctor or nurse may give you specific treatments, which may include lotions, moisturizers, or pain medicines such as ibuprofen or acetaminophen
  • Discuss this side effect with your doctor or nurse so he or she can perform a full evaluation

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

    While on treatment, you may feel tired or weak. Fatigue is common during treatment for cancer. But it may also be a sign of a more serious medical problem. Call your doctor or nurse for a full evaluation if you feel tired or weak while on your treatment.

  • Take short naps or breaks
  • Eat well and drink plenty of fluids
  • Take short walks or do light exercise if you feel up to it
  • Try to maintain normal work and social schedules

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may experience fever. It's important to call your doctor for a full evaluation at the first signs of fever.
To help manage your fever, your doctor may prescribe:

  • Intravenous fluids
  • Antibiotics (if the doctor thinks the fever is the result of an infection)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen
  • Your doctor may change your dose or suggest diet changes if you have continued fever

Your doctor may take you off your dose if you have continued fever.

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

Diarrhea is defined as 3 or more loose or watery stools/bowel movements in one day. If you have these symptoms, call your doctor or nurse. It is important for you and your doctor to try to manage diarrhea as soon as it begins.

Once the diarrhea resolves:

  • Ask your doctor or nurse if you can be treated with over-the-counter medications
  • Try yogurt containing probiotics
  • Eat foods containing fiber–especially soluble fiber which can be found in oatmeal, nuts, beans, and apples
  • Eat small but frequent meals
  • Avoid spicy foods, fatty foods, caffeine, and fruit
  • Drink lots of fluids, but in small amounts

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

    Nausea is defined as feeling as if you are about to throw up. It is best to call your doctor or nurse at the first sign of nausea or vomiting. This is especially important if these symptoms keep you from taking your oral medications. Your doctor may prescribe a medicine for these symptoms.

  • Eat small meals
  • Avoid foods that are sweet, fried, or fatty
  • Drink lots of fluids, but in small amounts
  • If you vomit, start with small amounts of water, broth, or other clear liquids when you are ready to eat again
    • If that stays down, then try soft foods. Some examples include gelatin, yogurt, strained soup, or cream of wheat. Slowly work up to eating solid food. Make sure that you do not eat any food that you are allergic to

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on your treatment, you may develop mouth pain. Your symptoms may include mouth sores, redness, a white coating of the tongue, bleeding gums, trouble swallowing, or cracks in the corners of your mouth. Call your doctor or nurse if you experience any of these problems.

Mouth pain as a result of treatment does not usually pose a health risk. However, blistering and peeling on the inside of your mouth may be a sign of a more serious side effect. If you develop mouth pain, tell your doctor immediately. He or she may tell you to stop your treatment.

  • Avoid hot, spicy, or acidic foods
  • Eat foods that are soft
  • Use a straw for drinking liquids
  • Use an alcohol-free mouthwash, and rinse your mouth often with water
  • Avoid toothpastes with whiteners (ie, peroxide) and use a soft toothbrush
  • Ask your doctor if there are over-the-counter or prescription medications that may help you manage your condition

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may experience an upset stomach. Upset stomach is common for patients who are being treated for cancer. Call your doctor or nurse if you have an upset stomach.

  • Avoid heavy meals, coffee, and alcohol
  • Sleep in a more upright position, propped up on a pillow
  • Reduce your stress with meditation, yoga, or music
  • Ask your doctor if there are over-the-counter or prescription medications that may help you manage your condition

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may experience headache, back pain, joint pain, and extremity pain.

  • Drink more fluids
  • Increase physical activity
  • Take pain medicines such as ibuprofen or acetaminophen
  • Ask your doctor about adjusting your dose

Speak to your doctor or nurse if you experience bodily pain.

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may experience constipation.

  • Drink more fluids
  • Take a stool softener and a laxative
  • Add fiber to your diet
  • Increase physical activity
  • Get an enema
  • Ask your doctor about adjusting your dose

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, foods you usually enjoy may taste bland, different, or bad. Call your doctor or nurse if you experience taste changes.

  • Try cold or frozen foods as they may taste better than hot foods
  • Flavor your food with herbs, seasonings, sugar, or sauces
  • Keep a clean and healthy mouth by brushing and flossing often

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may have less desire to eat. But maintaining good nutrition and a healthy weight are important to your treatment. Protein and calories are even more vital to someone with cancer.

  • Eat several small meals a day—5 or 6 isn't out of the question
  • Eat when you are hungry
  • Enjoy snacks and try to make them nutritious. Find calories and protein in dried fruits, nuts, cheeses, and even milkshakes
  • Add gravy, butter, or cheese to your favorite foods for added protein and calories
  • Drink fluids between meals rather than filling up with them during meals
  • If you are too tired to cook, ask a friend or family member to make you something. You may be surprised how many people you have to help
  • If the smell of a certain food is bothering you, it may help to eat it cold or at room temperature
  • If you're having trouble tasting your favorite foods, try adding herbs or condiments
  • A registered dietitian (RD) may have more ideas to offer you

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

    While on treatment, swelling or edema may occur. If you have swelling of your face or mouth while taking your treatment, it may be a sign of a serious side effect.

  • Maintain a balanced diet, while cutting down on salt
  • Walk and exercise. This can help increase circulation and reduce swelling
  • Wear compression socks or elastic sleeves. This can help with your circulation and reduce swelling
  • Elevate your arms or legs when sitting or lying down
  • Take natural diuretics such as green, leafy vegetables (especially if you are taking enemas)
  • Your doctor may prescribe diuretics
  • Ask your doctor or nurse to perform a full evaluation

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

You treatment may be causing you to cough.

  • Drink more fluids
  • Take hot showers
  • Use a vaporizer
  • Talk to your doctor or nurse if you think your treatment may be causing you to cough, as they may suggest something to reduce your coughing

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may feel shortness of breath. This may feel like you can’t get enough air, or it may just be uncomfortable to breathe normally.

    Your doctor may recommend some of the following:

  • Try getting extra oxygen, for example, by sitting in front of a fan
  • Try breathing clean, cool air. Cooler temperatures and fresh air can make a big difference
  • Keeping your head up. If you are in bed, raise your head and back with pillows so you are closer to sitting up
  • Take part in relaxation techniques such as meditation, which may also help

You and your doctor may be able to manage some side effects. Others, however, may not be manageable. If you’re having some side effects, your doctor may decide to adjust your dose or interrupt your treatment. That’s why it’s important to tell your healthcare team about ANY side effects you are experiencing.

Always talk to your doctor or nurse about any side effects you have as soon as you notice them. Do not wait until they become serious.

While on treatment, you may experience bleeding disorders. When this happens, the blood does not clot normally. This can cause prolonged or excessive bleeding. Call your doctor immediately if you have any swelling or bleeding during treatment.

    To help manage your bleeding, your doctor may prescribe:

  • Vitamin K injections
  • Clotting agents
  • Blood plasma or platelet transfusions
  • Medication for platelet problems

Call your doctor if you have any swelling or bleeding during treatment with SUTENT.

Serious Side Effects

Some side effects are more serious than others. Discuss these potential side effects with your doctor. Let your doctor know if you experience any of the warning signs in this section.

Click the name of each side effect to learn more. Print all

SUTENT can cause serious liver problems, including death.

    Tell your doctor right away if you develop any of the following signs and symptoms of liver problems during treatment with SUTENT:

  • Itching
  • Yellow eyes or skin
  • Dark urine
  • Pain or discomfort in the right upper stomach area

Your doctor should do blood tests to check your liver function before you start taking SUTENT and during treatment.

    SUTENT may cause heart problems, including:

  • Heart failure
  • Heart attack
  • Heart muscle problems (cardiomyopathy)
    • Tell your doctor if you feel dizzy, faint, very tired, have abnormal heartbeats, are short of breath, or have swollen feet and ankles
  • Abnormal heart rhythm changes
    • Your doctor may do electrocardiograms and blood tests to watch for these problems during your treatment with SUTENT. Tell your doctor if you feel dizzy, faint, or have abnormal heartbeats while taking SUTENT

While on treatment, your blood pressure may rise. You may receive treatment for high blood pressure (hypertension). Tell your doctor or nurse if you already have high blood pressure or a history of heart disease. If you are receiving treatment, your doctor may change it as needed. In cases of very high blood pressure, your doctor may stop your medication temporarily until your blood pressure is controlled.

  • Your doctor may also ask you to track your blood pressure regularly in a diary

    SUTENT may cause bleeding sometimes leading to death. Tell your doctor right away if you have any of the following symptoms:

  • Serious bleeding problem
  • Painful swollen stomach (abdomen)
  • Vomiting blood
  • Black, sticky stools
  • Bloody urine
  • Headache or change in your mental status

Your healthcare provider can tell you other symptoms to watch for.

Call your doctor if you have any swelling or bleeding during treatment with SUTENT.

Severe jaw bone problems may happen. Your healthcare provider should examine your mouth before you start SUTENT. Your healthcare provider may tell you to see your dentist before you start SUTENT.

TLS is caused by the fast breakdown of cancer cells and may lead to death. TLS may cause you to have nausea, shortness of breath, irregular heartbeat, clouding of urine and tiredness associated with abnormal laboratory test results (high potassium, uric acid and phosphorus levels and low calcium levels in the blood) that can lead to changes in kidney function and acute kidney failure. Your healthcare provider may do blood tests to check you for TLS.

Damage to the smallest blood vessels known as thrombotic microangiopathy (TMA) may occur. TMA is a condition involving injury to the vessels resulting in blood clots, and is accompanied by injury to red blood cells leading to a decrease in red cells and a decrease in cells that are involved with clotting. TMA may harm organs such as the brain and kidneys. Symptoms of TMA may include fever, fatigue, tiredness, bruising; you may develop swelling, confusion, vision loss, and seizures. Your healthcare provider may tell you to stop taking SUTENT.

Your healthcare provider will check you for this problem. If there is too much protein in your urine, your healthcare provider may tell you to stop taking SUTENT.

SUTENT can cause serious skin reactions that can cause death. This can include rash, widespread blistering or peeling of the skin and blistering and peeling on the inside of your mouth. If you develop a rash or these skin symptoms, tell your healthcare provider immediately. Your healthcare provider may tell you to stop taking SUTENT.

Your healthcare provider may do tests to check your thyroid and adrenal gland function during SUTENT treatment.

Tell your doctor if you have any of the following signs and symptoms:

  • Tiredness that worsens and does not go away
  • Loss of appetite
  • Heat intolerance
  • Feeling nervous or agitated, tremors
  • Sweating
  • Nausea or vomiting
  • Diarrhea
  • Fast heart rate
  • Weight gain or weight loss
  • Feeling depressed
  • Irregular menstrual periods or no menstrual periods
  • Headache
  • Hair loss

Low blood sugar can happen with SUTENT, and may cause you to become unconscious, or you may need to be hospitalized. Low blood sugar with SUTENT may be worse in patients who have diabetes and take anti-diabetic medicines. Your healthcare provider should check your blood sugar levels regularly during treatment with SUTENT and may need to adjust the dose of your anti-diabetic medicines. Signs and symptoms of low blood sugar may include:

  • Headache
  • Drowsiness
  • Weakness
  • Dizziness
  • Confusion
  • Irritability
  • Hunger
  • Fast heart beat
  • Sweating
  • Feeling jittery